Maryland’s new bill to expand healthcare for small business employees


James Sklar


While there are around 620,214 small businesses in Maryland, which employ over 1.2 million employees in the state, the Baltimore Sun reports that only about 37% of small businesses in the state of Maryland provide health coverage to their employees compared to 95% of large employers who provide their employees with coverage.


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Currently, Maryland’s small businesses can get federal tax credits to lower their costs if they go through Maryland Health Connect, which enables small businesses and their employees to compare and shop for private plans. According to, small businesses can qualify for tax credits that could be worth up to 50% of the costs for the employees premiums.

On January 11th, 2023, Sen. Katie Hester (D – Howard) and Del. Robbyn Lewis (D – Baltimore) introduced Senate Bill 59 and House Bill 107, respectfully. SB0059 and HB0107 would create a special enrollment period for individuals who become employed by a small employer that does not offer their employees health benefit plans. The enrollment window would be open for 60 days after the employee’s first day of employment. Additionally, these bills would allocate funding until 2029 for marketing and outreach for this special enrollment period.

Currently, starting a new job would not make an individual eligible for a special enrollment period because this would not be considered a qualifying life event. This new legislation would eliminate this barrier for people seeking health insurance.

Lewis and Hester are continuing their advocacy for health insurance coverage for small businesses through the legislative process. Last year, they sponsored a successful effort to establish the Small Business and Nonprofit Health Insurance Subsidies Program, which provides subsidies to purchase health insurance for their workers.

The passage of SB 632 also created a workgroup tasked with monitoring the impact of the program and researching ways to support the healthcare needs of small business employees. The workgroup met from July to September and concluded that additional outreach and training for small businesses would be a significant improvement for small businesses seeking to expand their healthcare benefits. The marketing piece is a key aspect of the two 2023 bills.

“This is the most efficient and effective use of state funds to increase health coverage right now in Maryland, and we look forward to implementing each [of the workgroup’s recommendations] in the next legislative session.” Hester said of the 2023 bills during a press conference last November.

During the same press conference, Lewis emphasized the important role the state’s health insurance marketplace plays in the legislation by spreading advocacy through things like workshops, training, and events.

“Through marketing and outreach by the Maryland Health Benefit Exchange and partnering with small employer groups and the producer community, the state would help ensure that small employers and their employees are educated about their coverage options and will enroll,” Lewis said.

The Maryland Citizens’ Health Initiative is strongly supportive of SB 59 and HB 107 and has identified the effort as one of its main legislative priorities for 2023. SB 59 is scheduled for a hearing on February 1st at 1:00 p.m.